Psypath: behaviorist appr. to treating phobias AO1+3

Question 1

Both based on which principle?

Answer 1

Counter-conditioning: new response to phobic stimulus learned by pairing w/relaxation, not anxiety

Question 2

reciprocal inhibition?

Answer 2

Patients respond to a feared stimuli w/relaxation, not anxiety
fear + relaxation can’t co-exist

Question 3

Anxiety hierarchy

Answer 3

client + therapist design list/hierarchy of frightening/stressful events/objects

Question 4

Relaxation

Answer 4

Client taught deep muscle relaxation
Impossible to be afraid+ be relaxed at the same time
Involves breathing exercises/meditation/mental imagery
Can involve drugs (e.g. valium) or hypnosis

Question 5

Gradual exposure

Answer 5

Helps client work up hierarchy while maintaining deep relaxation

Question 6

How do flooding + systematic desensitisation (SD) differ?

Answer 6

Flooding-> exposing phobic patients to fear w/out gradual build-up in anxiety hierarchy
Immediate exposure to frightening situation- prevents avoidance

Question 7

What does flooding stop a pt doing?

Answer 7

avoidance

Question 8

how many sessions needed?

Answer 8

1 session can last 2/3 hrs
1 session can be all needed

Question 9

how does flooding work?

Answer 9

Stops phobic responses quickly: prevents avoidance behaviour, pt learns phobic stimulus is harmless (extinction in CC)
Learned response extinguished when conditioned stimulus (e.g. dog) is encountered w/out learned fear response (CR) association w/the UCS is broken: CS no longer produces CR (fear)
Pts can achieve relaxation- they are exhausted by fear response from immediate exposure

Question 10

Strength SD -> supportive empirical ev. to demonstrate effectiveness

Answer 10

E-McGrath et al (2009)- 75% of patients w/phobias responded to SD- most effective due to the in vivo techniques (actual contact w/fear stimulus more effective than imagery-based techniques).
E-Gilroy et al (1990) examined 42 patients w/arachnophobia using 3x 45 min sessions- found reduced fear 33 months later, compared to a control group (relaxation techniques only)
L- empirical ev. increases treatment validity to overcome phobias

Question 11

Strength SD -> preferred as a treatment for phobias by patients to flooding

Answer 11

E- doesn’t cause same lvls of distress w/ immediate prestation of ear-inducing stimulus- low attrition rates
E- considered more appropriate treatment for pts w/ severe anxiety disorders- learning relaxation techniques can be a positive + pleasant experience
L- SD may be seen as more ethical treatment for these patients

Question 12

Strength SD-> used to help pts who can’t access other treatments, e.g. pts w/learning disabilities

Answer 12

E- ppl requiring treatment for phobias have learning disabilities, but main alternatives to SD = unsuitable.
Ppl w/learning disabilities struggle w/cognitive therapies requiring complex, rational thought
E- may feel confused/distressed by traumatic experience of flooding
L- SD = most appropriate treatment for ppl w/learning disabilities + phobias

Question 13

Strength SD-> used w/ VR, not irl

Answer 13

E- exposure through VR used to avoid dangerous situations (e.g. heights), cost-effective as psychologist + pts don’t have to leave consulting room
E- but, has evidence to suggest VR exposure = less effective than real exposure for social phobias, lacks realism (Wescler et al. 2019)
L- means advantages of VR based SD could be suitable for some, not all, phobias

Question 14

Limitation SD -> not effective in treating all phobias

Answer 14

E- pts w/phobias not developed through a personal experience (CC), e.g. fear of snakes, not effectively treated using SD, can’t be that their phobia has been learnt + can’t be unlearnt
E- some psychologists say certain phobias have evolutionary survival benefits + are not a result of learning
L- limitation of SD, ineffective in treating evolutionary phobias w/ an innate bias

Question 15

Strength flooding -> as effective as other treatments + most cost effective

Answer 15

E- Ougrin (2011) compared flooding-cognitive therapies: flooding is effective + quicker than others
Quick effect= strength, pts free of symptoms asap- treatment = cost-effective
E- has implications for economy, could reduce financial burden on NHS- offering a quicker + cheaper treatment for phobics
L- flooding can be useful + could be first type of treatment for NHS patients

Question 16

Limit flooding -> not suitable for all, v. traumatic

Answer 16

E- Schumacher (2015) found patients + therapists rated flooding as more stressful than SD
Problem ≠ flooding is unethical (pts give informed consent) but are unwilling to see it through- can be distressing
E- intensity of experience can lead to high attrition rates (ppl drop out) + can make phobia even worse if treatment is not completed
L- shows individual differences can be limitation of effectiveness of flooding as treatment for phobias

Question 17

Limit flooding -> inappropriate for phobias needing high lvls of cognition (soc. phobias)

Answer 17

E- e.g. sufferer of a social phobia experiences an anxiety response + thinks unpleasant thoughts abt the social situation
E- mb more beneficial for more complex phobias to be treated w/cognitive therapies bc therapies tackle irrational thinking
L- whilst flooding mb appropriate in some situations, it may not be useful for all phobias + reduces usefulness as a treatment

Question 18

How does behavioral appr. to treating phobias link to reductionism?

Answer 18

• Behavioral exp. mb too simplistic in reducing complex behaviour to simple S-R association
• Ignores role of cognition: phobias mb bc of irrational thinking

Question 19

How does behavioral appr. to treating phobias link to determinism?

Answer 19

• Ignores role of free will in formation of phobias, implying envir. determinism
• Not every1 bitten by a dog develops fear of them: other processes must be involved

Question 20

How does behavioral appr. to treating phobias link to nomothetic/idiopathic?

Answer 20

• Suggests nomothetic approach, implying universal laws
• But if individual cognition plays a part, a more idiographic approach mb preferred

Question 21

counter-conditioning

Answer 21

new response from phobic stimulus learned by pairing w/relaxation not anxiety

Question 22

systematic desensitisation

Answer 22

pts respond to feared stimulus w/relaxation not anxiety

Question 23

anxiety hierarchy

Answer 23

list including stressful objects/events

Question 24

reciprocal inhibition

Answer 24

can’t experience fear + be relaxed at same time/simultaneously

Question 25

extinction

Answer 25

pts quickly learn phobic stimulus=harmless

Question 26

flooding

Answer 26

stopping phobic responses quickly

Question 27

McGrath et al (1990)

Answer 27

75% of pt w/phobias responded to SD- more effective in vivo techniques than in imagery-based techniques

Question 28

Gilroy et al (1990)

Answer 28

Examined 42 patients w/arachnophobia using 3x 45 min sessions- found reduced fear 33 months later, compared to a control group (relaxation techniques).

Question 29

Weschler et al (1990)

Answer 29

VR exposure may be less effective than real social phobia exposure- lacks realism.

Question 30

Ougrin et al (2011)

Answer 30

Compared flooding to other cognitive therapies- found it is highly effective + quicker than alternatives- pts are free of symptoms asap.

Question 31

Schumacher et al (2015)

Answer 31

Pts + therapists rated flooding more stressful than SD- patients unwilling to finish- can be very distressing.